Organization
GULF COAST PATHOLOGY PROGRAM PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JAMAINE DAVIS (CHIEF FINANCIAL OFFICER)
(561) 402-4256
Entity
Organization
Contact information
Practice address
7600 FANNIN ST, HOUSTON, TX 77054-1906
(713) 791-7126
Mailing address
PO BOX 746559, ATLANTA, GA 30374-6559
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
11/10/2023
Last updated
11/10/2023
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